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New Applicant/Existing Member Information Please print all information |
| Applicant/Member Name___________________________________________________ |
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Mailing Address Line 1__________________________________________________ |
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Mailing Address Line 2__________________________________________________ |
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City___________________ State _______Zip____________ |
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Primary Phone Number(____)____________ext _____Type_________ (e.g. Office, Home, Mobile, Pager, Other) |
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Alternate Phone Number(____)__________ext _____Type_________ (e.g. Office, Home, Mobile, Pager, Other) |
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E-Mail Address_____________________________________________ |
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Applicant CHL License Number or enter "Awaiting Issue"__________________ Exp. Date (mm/yy)_________ State_____ |
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CHL Instructor Name or enter "Unknown" _______________ CHL Instructor City_______________ |
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How did you find CHLPP?____________________________________________ |
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Comments/Other___________________________________________________ |
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The CHLPP Joint Plan provides coverage for yourself and your
joint applicant(s) at a discount. Please contact CHLPP Customer Service at Toll Free 866-851-9744
for a quotation for additional joint applicant members. |
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Joint Applicant Name ____________________________________________ |
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Joint Applicant CHL License Number or enter "Awaiting Issue"_______________ Exp. Date (mm/yy)________State____ |
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Applicants: We understand the written contract sets forth the
terms of our CHLPP membership including any exclusions or
limitations, and agree to be bound by the same. We further
understand the company will mail the written contract to us at
our address stated above within the next thirty (30) days. If we
have not received our contract within thirty (30) days, we
understand that it is our responsibility to call CHLPP Customer
Service at Toll Free 866-851-9744 to obtain a copy. The written
contract, together with this application, constitutes the entire
agreement between the company and the individual member with
respect to the membership, and there are no agreements,
understandings, warranties, or representations other than as set
forth herein and in the membership contract. We have or are
awaiting issue of a valid CHL license or permit. We understand
that CHLPP covers only acts of self-defense. We certify we are
legally residing in the United States of America. CHLPP will not disclose any applicant and/or membership information other than incidental information required for servicing application without prior consent of applicant and/or member. |
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| $129 one (1) year Individual Plan CHLPP membership fee | |
| $229 two (2) year Individual Plan CHLPP membership fee and receive your choice of a FREE book! | |
| $399 four (4) year Individual Plan CHLPP membership fee and receive your choice of a FREE book! | |
| $229 one (1) year Joint Plan CHLPP membership fee | |
| $329 two (2) year Joint Plan CHLPP membership fee and receive your choice of a FREE book! | |
| $599 four (4) year Joint Plan CHLPP membership fee and receive your choice of a FREE book! | |
| Your annual, two, or four year CHLPP membership will begin from the date of receipt of your funds or the issuance of your concealed handgun license, whichever is later. Your CHLPP membership information will be mailed to you upon receipt of your credit card information, check, or money order. Your check/money order must be payable in U.S. dollars to CHL Protection Plan. Do not send cash! You will receive a membership renewal notification email fourteen (14) days and seven (7) days in advance of your membership expiration. | |
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| Renewal of my existing/expired CHLPP membership | |
| Your paid multi-year CHLPP membership entitles you to a FREE copy of one of the following books: | |
| No book | |
| "The Concealed Handgun Manual" by Chris Bird, a $22.95 value! | |
| "Thank God I Had a Gun" by Chris Bird, a $19.95 value! | |
| "Gun Laws of America" by Alan Korwin with Attorney Michael P. Anthony, a $19.95 value! | |
| "Texas Gun Owners Guide" by Alan Korwin and Georgene Lockwood, a $14.95 value! | |
| "Traveler's Guide to the Firearm Laws of the Fifty States" by J. Scott Kappas, Esq., a $13.95 value! | |
| "The Complete Gun Owner" by James M. Ayres, a $24.99 value! | |
| "Self-Defense Laws of All 50 States" by Attorney Mitch Vilos & Evan Vilos, a $29.95 value! | |
 Click on image for details about each book |
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| Credit Card Type (circle one) MasterCard Visa Discover American Express | |
| Name as it appears on credit card_______________________________________ | |
| Credit card #_______________________________________Exp. Date (mm/yy)_______ | |
Card Security Code _______ 
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| Check#___________ Amount________________ | |
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Please contact me about representing the CHL Protection Plan as a commissioned sales representative |
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Complete this form, make a copy for your records, and mail it with your payment to: CHL Protection Plan 11700 Preston Rd, Suite 660-531 Dallas, Texas 75230 |
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